Saturday, December 2, 2006

The Burn Unit

Yesterday I went to Sulaimaniyah emergency hospital's burn unit to try to talk to some women. Why does the hospital, which isn't exactly the best in Iraq or the Middle East, have a burn unit?

It's in large part because people here who attempt suicide do so by setting themselves on fire. It's a common technique employed by Iraqi and Iranian Kurdish women who haven't had access to things like pills, and have traditionally ended their lives by soaking their bodies (from the head down) in kerosene and lighting a match.

The number of suicide cases is said to be rising, but it's hard to know if that's true or by how much. Statistics aren't exactly reliable here. Taking one's life is culturally and religiously forbidden in predominantly Islamic Kurdistan, so survivors rarely admit that they were trying to commit suicide. They instead claim it was an accident, but doctors are often suspicious that victims – especially women – were attempting suicide.

Many of the cases are in fact caused by generator and fire related accidents. A smaller number are believed to be murders: Someone puts a bullet in a woman's head and then sets her alight. Assumptions are made; an autopsy is skipped.

I naively thought that I could get some women survivors to open up to me and proved unsuccessful. Which makes sense: Why would a woman who tried to end her life open up to a stranger who randomly walks into a hospital?

Well, some just want to be listened to. There isn't any psychological help for those who need it. Iraqi Kurds who survived decades of war, genocide, torture, displacement and a host of internal conflicts, have zero medical mental health resources. There are religious leaders and families, of course, but only a handful of psychologists.

The women rejected my requests for interviews except at the end of my two-hour stay, when I unfortunately had to leave for another appointment. But I did end up talking to a young man who admitted that he had attempted suicide and appeared severely emotionally disturbed.

I had to wear a face mask and scrubs in the hospital, and as I got dressed I grew nervous. I had never seen a burn victim before, but I'm notoriously bad with blood and didn't want to become lightheaded during the interview. The young man, who was 27, had already been through enough and didn't need a reporter passing out on him.

He had lit himself on fire while drunk, but this wasn't his first suicide attempt. In fact, he estimated he had tried to kill himself 50 or so times. The fact that he hadn't succeeded made me think he was crying out for help, as we say in the States. He and his father blamed his problems entirely on drinking and drugs.

The young man was almost entirely wrapped in gauze and covered with a white sheet. He shook violently from the fever, particularly when he spoke, but said he wasn't in pain. He just seemed incredibly sad, lost, hopeless and, as he said himself, totally out of control. My sadness for him overwhelmed my fear.

There was only one other man in the men's ward, (there are separate sections for women and children) and he bore burn marks on his face. He, like many others who enter the unit, was burned in an accident with a kerosene heater or a generator. Running them is a dangerous necessity in Iraq; there's little electricity and therefore no heat in winter (or air in summer.)

The medical assistant I talked to pointed out that suicides happen everywhere. He was in part trying to emphasize that just because Kurds have a different way of killing themselves, they aren't freaks.

Is burning yourself alive really much worse than putting a gun to your head, or slicing your wrists open with a razor blade? I'm not sure. But the assistant also said something else revealing: He didn't think medical staff needed to answer why someone tried to hurt themselves; that it was their responsibility simply to heal them.

But what does healing mean? There aren't any psychologists, social workers or psychiatrists on staff at the hospital, so fevers are reduced, skin heals or is repaired and burn victims are sent home. But there is no attempt within the medical community to help those who attempted suicide understand why they took that drastic step and prevent it from happening again.